Criteria for referral into WCH Outpatient departments have been developed so that referring Medical Practitioners have the tools available to make a comprehensive referral, ensuring that clients receive an appropriate appointment.
Paediatric Outpatients
Contact
Referral Criteria for Specialist Outpatient Services
Current Clinic and Doctor listing
Women's Outpatients
Please complete the ‘Referral to Women’s and Children’s Hospital Outpatient Department’ form, using one of the options below. The form must be completed and signed by the referring Medical Practitioner and faxed to the Admin Hub for processing.
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Web-based – this form is designed to be completed online. This form has been designed for referring practitioners who do not have a practice software package. The form has drop down menus and checkboxes for ease of use. |
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Best Practice – click here to download The template can only be opened once imported into Best Practice, opening the template before it is installed will break all the automated links within the template. INSTRUCTIONS
Please check the Clinic and Doctor list or contact the the Admin Hub on 8161 7399 to determine which Doctors work in a clinic. The Clinic and Doctor list will be updated monthly to ensure the WCH Clinic and Doctor lists are up to date. |
| 3. | Genie users will need to download a copy to their own database in order to use the form within their practice. INSTRUCTIONS:
This template can then be accessed in Genie by selecting the patient record, clicking on the golden pages icon and opening the GS_WCH_Referral_form_SA template from this list. |
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Medical Director – click here to download The template can only be opened once imported into Medical Director, opening the template before it is installed will break all the automated links within the template. INSTRUCTIONS:
Please check the Clinic and Doctor list or contact the the Admin Hub on 8161 7399 to determine which Doctors work in a clinic. The Clinic and Doctor list will be updated monthly to ensure the WCH Clinic and Doctor lists are up to date. |
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MedTech – click here to download The template can only be opened once imported into Medtech. INSTRUCTIONS:
Please check the Clinic and Doctor list or contact the the Admin Hub on 8161 7399 to determine which Doctors work in a clinic. The Clinic and Doctor list will be updated monthly to ensure the WCH Clinic and Doctor lists are up to date. |
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ZEDMED – click here to download The template can only be opened once imported into ZEDMED, opening the template before it is installed will break all the automated links within the template. INSTRUCTIONS:
Please check the Clinic and Doctor list or contact the the Admin Hub on 8161 7399 to determine which Doctors work in a clinic. The Clinic and Doctor list will be updated monthly to ensure the WCH Clinic and Doctor lists are up to date. |
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Ear, Nose and Throat (ENT) referral form |
Please see referral criteria prior to referral. Please use the web-based form. |
All versions of this form should be signed by the referring medical Practitioner prior to faxing it to the Administrative Hub.
Referrals will only be accepted on the official 'Referral to Women’s and Children’s Outpatient Department' form. We cannot accept referral forms that are incomplete or that have not been signed by the referring medical Practitioner.
If you have any queries about using this form, referring a client to a WCH Outpatient clinic or booking an appointment please call the Administrative Hub on 8161 7399.
The WCH requires a complete referral to ensure the client is given an appropriate priority for an appointment. The ‘Referral to Women’s and Children’s Out Patient Department’ form has been designed to ensure that all the information required to offer a timely and appropriate service to your client is received.
The form has been divided into the following sections:
Please provide as much detail about your client as possible to ensure we can contact them regarding appointments
Is the client of Aboriginal or Torres Strait Islander origin?
Why do we ask this question?
Australia's Aboriginal and Torres Strait Islander peoples occupy a unique place in Australian society and culture. This group also experiences the worst health outcomes of any population group in Australia, therefore in SA Health facilities we prioritise access to services for all Aboriginal patients. In the current climate of reconciliation, accurate and consistent statistics about Aboriginal and Torres Strait Islander peoples are needed in order to plan, promote and deliver essential services, to monitor changes in wellbeing and to account for government expenditure in this area.
Is the client under the guardianship of the minister?
The South Australian Government, through the Department of Families and Communities, has a significant responsibility in ensuring that all children and young people are safe, and that families experiencing challenges receive adequate support.
SA Health has a formal commitment to ensure that all children and young people under the guardianship of the Minister have access to priority health services to improve their health outcomes.
Interpreter required
Does the client require an interpreter? If 'Yes', please document the language spoken by the client, not their nationality.
TIP: To search for the language spoken in the web-based version, type the first few characters of the language
Length of referral
Please choose the appropriate referral option from the drop down list.
Clinic and Doctor name
The method of entering this information is dependant on the form being used.
The web-based form has drop down menus for the referring Doctor to choose the clinic and Doctor to refer to. This lisiting in the template will be updated monthly to ensure our clinic and Doctor lists are up to date.
When using the Best Practice version, refer to the
The clinic and Doctor lists will be updated in the Medical Director Template at each release of the product by HCN.
When using the PDF version, refer to the
Current Medical Problem/s
Please provide information regarding the presenting issue. Please forward relevant pathology reports and x-ray reports with this referral. In the web-based version, this text box will hold up to 1000 characters.
Past Medical History
Please provide information that will contribute to determining the priority assigned to the client. This should include all current medications, relevant allergies and immunisations. In the web-based version, this text box will hold up to 1000 characters.
Referring doctor name and address, surgery name and *medical provider number.
* We request Referrer provider numbers to ensure correct identification of Medical Practitioner in the event of a similar name, and for the subsequent linking of the referral information to the correct patient appointment.
Print the form. Sign and date the form, then fax to the WCH Administrative Hub at 8160 6246.
NOTE: If you have any queries about using the form, referring a client to a WCH Outpatient clinic, or booking an appointment please call the Administrative Hub on 8161 7399.
